Source: http://adventuredoc.net/2012/10/24/hiv-vaccines-and-the-future/
Tuesday, April 30, 2013
Learn How LASIK Could Make Those Resolutions Easier To Keep
What: Happier New You LASIK event at Eye Consultants of Texas, 2201 Westgate Plaza in Grapevine, conveniently located to Dallas/Fort Worth
When: Tuesday, January 22, 2013, 6:30 to 7:30 PM
Cool Part: $300 off any LASIK procedure just for attending
Now that the big ball has fallen and the calendar has started over, it’s time to think about those new year’s resolutions. Or, more importantly, how to stick to them.
If you’ve worn glasses or contacts for most of your life, you might consider adding LASIK to your 2013 list. Not only can LASIK help you see much clearer, but by not having to depend on corrective eyewear, it can make life a lot easier and generally more fun. Plus, it makes exercise and just getting out easier too. LASIK could possibly even save you money over wearing glasses and contacts. So even if you’re just sticking to the basics of wanting to be healthier, spending less money and having more fun, then LASIK might be a good start to keep you on the right track – 2013 and beyond.
Our Happier New You LASIK event could be the perfect opportunity to get the full story on LASIK and what to expect. It’s free and only 60 minutes long. And, if you decide to have your procedure here you get $300 off just for attending. Call us in Grapevine at 877-516-4364 to reserve your space today or to get more information (must be 18 years or older to attend). We look forward to seeing you!
Source: http://www.eyectexas.com/blog/lasik-resolutions/
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Reasons To Love LASIK February Event
Everyone knows that February 14 is a special day for your heart. We’re making February 19 a special day for your eyes, when we host our Reasons To Love LASIKevent in the comfort of our state-of-the-art offices in Grapevine. If you’ve ever considered LASIK, we’ll give you the straight story in a way you might find refreshing; perhaps pick up something you didn’t realize, even if you’ve been doing your homework.
When: Tuesday, February 19, 6:30 to 7:30 PM
Where: Eye Consultants of Texas, 2201 Westgate Plaza, Grapevine, TX 76051
Cost: Free
Led by one of our expert doctors, you’ll learn all about what LASIK is like – including costs, the procedure and generally what to expect. By the way, if we perform LASIK on anyone who attends (after a thorough evaluation), we’re offering $300 off their LASIK procedure.*
So please join us for this informative, FREE event. Reasons To Love LASIK only lasts 60 minutes and might be just the information you’re looking for. You’ll also have plenty of opportunities to ask questions. To reserve your space, call our Grapevine office at 877-516-4364. We’re conveniently located to Dallas and Fort Worth.
*For attendees scheduling an evaluation who are determined to be a LASIK candidate. Must be 18 years or older to attend. Must be present to receive LASIK offer.Source: http://www.eyectexas.com/blog/reasons-to-love-lasik-february-event/
Influenza in the United States
There has been a severe start to the flu season in North America, with many more people than usual falling ill.
Travellers visiting America should be vaccinated against influenza.
Influenza may also be caught anywhere where there are crowds of people in close proximity, such as shops, airports, cinemas, etc.
For advice about influenza and other travel related illnesses and vaccinations, contact the Globe Travel Health Centre in Norwich on 01603 667323 – we have influenza vaccine in stock and can vaccinate anybody over the age of one year against flu
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What is Natural Cycle IVF?
Conventional IVF Today’s conventional IVF is ‘stimulated’ – drugs are used to prompt the woman’s ovaries to produce several eggs, rather than just one. The eggs are mixed with her partner’s or a donor’s sperm to become fertilised. Women take a course of ovarian-suppression hormones to shut down their menstrual cycle to control ovulation. Then [...]
Source: http://www.createhealthclinics.org/blog/natural-cycle-ivf/what-is-natural-cycle-ivf/
New York State Governor Investigates Out-Of-Network Costs
New York State Governor Andrew Cuomo recently announced the continuation of an investigation into out-of-network medical costs. In 2011, the state received more than 2,000 complaints from consumers who unexpectedly received bills from out-of-network specialists and providers after taking measures to choose in-network providers and receive prior insurer approval. Consumers often are not told in advance which specialists are out-of-network, how much they charge, and how much of their fee will be covered by health insurance. The resulting bills contribute to financial strain on consumers, many of whom are unable to pay the amount charged and some of whom are forced into bankruptcy.
To aid consumers in obtaining information on out-of-network care, costs, and coverage, the New York State Department of Financial Services is calling for more transparency, better consumer protection, and system-wide reform. This follows efforts by the Obama administration to require health insurers to provide such easy-to-understand information to consumers. If you are concerned about the potential impact of reforms and new rules, please feel free to contact us to discuss your options and assist you in making decisions regarding your practice.
Source: http://www.pagingdrblog.com/2012/03/15/new-york-state-governor-investigates-out-of-network-costs/
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Bullying: A Physician’s Perspective
CTH Blog:
Bullying has been getting a lot more attention in the media, and it appears to be taken a lot more seriously now than in the past. As the chief of adolescent medicine for Kaiser Permanente in San Francisco, have you seen any increase in your practice in the number of adolescents coming in with concerns related to bullying?
Charles Wibbelsman:
In my own practice, I’ve seen an increase in bullying, anecdotally speaking, and that increase is reflected nationally as well. I was reading in The Journal of the American Medical Association, that 20 to 30 percent of students are involved in bullying – either as perpetrators or as victims.
We’ve had a teen clinic since 1955. When Solomon Cohen set up this clinic for adolescents ages 11 to 19, we were the only teen clinic in 1955, and we were one of the first teen clinics in the United States.
Bullying has changed over the last 20 years. It used to be that bullying would occur in the schools—students making fun of or physically assaulting other students, guys beating each other up, but now you have cyber bulling – social media, texting, Twitter, Facebook, and on-line videos. And, with cyber bullying, it’s mostly girls. Cyber bullying is twice as common among girls than boys.
CTH Blog:
Do you think bullying is becoming more common, or are people less tolerant of it now?
CW:
Bullying is more common because the factors involved in bullying are not just physical or verbal in a school setting. Again, now we have the bullying online as well. People are talking about it now. We’re seeing it in every type of media. People are more aware of it. It used to happen in the schools, and often teachers and parents weren’t aware of it. Now, people don’t look the other way. They are taking some responsibility.
CTH Blog:
The ramifications of bullying are serious. In addition to physical harm (from others or self), what are some of the health risks associated with bullying—the psychological and emotional health concerns that people may experience in response to bullying, such as anxiety, depression, headaches, or nausea?
CW:
There are serious health risks. Low self-esteem, depression, substance abuse, and suicide attempts. There are more than 250,000 attempted suicides, and 5,000 completed suicides among teens each year. The case of Rutgers University student Tyler Clementi, whose roommate filmed him being intimate with another man in a dorm room and uploaded the video, is an example of what can happen with bullying. Tyler committed suicide by jumping off the George Washington Bridge.
CTH Blog:
When you hear of tragedies such as what took place with Tyler Clementi, what is your reaction? There have been a growing number of adolescent and teen suicides that have been linked to bullying.
CW:
One of the saddest parts of my work was two years ago. A 14-year-old boy hung himself. He was one of my patients. His girlfriend broke up with him. He was popular, had lots of friends, good grades, played sports… It was horrible. It shows you how sensitive, vulnerable one is at that age. You don’t have the life experiences to deal with it.
I did a panel in San Francisco at the American Academy of Pediatrics, and there were LGBT youth talking about their own experiences being the victims of bullying. They were in their late teens, and all of them said that their worst experiences with bullying were in middle school. They all said, ‘I survived middle school.’ That’s the time when your body is changing, not everybody looks the same, there are school pressures – it’s prime time for bullying. There is decreased self-esteem. Bullying is at its height. Many young adults and adolescents don’t have the defense mechanisms to handle a lot of this.
CTH Blog:
Many kids who experience bullying suffer in silence, fearing retribution if they speak up. What are some of the warning signs adults should look for in kids?
CW:
Sometimes it’s unprotected sexual activity. I see isolation. I see cutting. When I see kids as patients, I ask, is this kid at risk for hurting himself? When I talk to adolescents about sexual orientation, maybe they’re gay or lesbian and haven’t come out yet. They’re very isolated. These are prime victims for bullying.
When we look at an adolescent, or when I’m examining a patient, I’m looking at self-esteem. How do they feel about themselves – their body? How do they relate to their body? If they have low self-esteem, it could be about low socio-economics, body weight, or sexual orientation. So, again, they may be at risk for depression, substance abuse, or suicide attempts.
We really need to talk with young adolescents in middle school, in junior high. Kaiser Permanente’s Educational Theatre Program is designed to do just that. They put on a theater performance called Nightmare on Puberty Street that addresses, in an entertaining way, the issues and difficult topics middle school students face. It looks at things like peer pressure, self-esteem, and bullying. I’m really proud of this program.
CTH Blog:
As a physician, you may be one of the few people an adolescent can talk to. You may be in a position to establish trust and an open line of communication in ways that others may not. What is the role of the health professional when it comes to bullying? Is the topic of bullying a regular part of the doctor-patient dialogue or should it be?
CW:
As a pediatrician, my responsibility as a doctor is to ask during routine checkups, how are you doing in school? I need to find out if he or she doesn’t have any friends, or if their grades are failing. Or, if one of my patients says, for example, ‘I want to change schools,’ that is a big red flag. As a physician, I often have access to information that adolescents don’t tell other people – things about substance abuse, depression, for example. I also partner with other physicians in mental health. At Kaiser Permanente it’s seamless. We’re all under one roof.
The bible of adolescent care is H-E-A-D-S – Home, Education, Activity, Drugs, and Sex. When I see a patient, at some point, I ask the parents to step out. We discuss a whole host of concerns. Home: I ask who do you live with? Do you live with both parents? I also ask about guns. Is there a gun in their life? Because maybe grandpa has a gun in the house, and a teen may have access to a gun. Activity: Are you involved in sports? What do you do in your free time? How much TV do you watch? I ask do you smoke? Sex: I ask them about what’s going on in their life. Are you having sex? Do you want to have sex, or are you being pressured? Because there are all kinds of layers. There could be issues concerning domestic violence. I start with the easier questions first, asking them what they like to do, and so forth. It’s about building trust and rapport.
CTH Blog:
In your practice, you emphasize the importance of communication with parents as well. Do you ask the parents some of these same questions?
CW:
Yes. We have a questionnaire for parents and adolescents. We ask some of the same questions and general questions as well. For example, does your child drink sodas? Is there a gun in the house? Are you concerned about any behaviors in your child? Is your child sad? Do they watch TV? What kind of things does your child like to eat?
CTH Blog:
What can communities and schools do differently to prevent bullying or minimize its effects?
CW:
Schools need to prepare teachers to be educated about bullying and intervene. Schools, principals, and students need to be aware about what’s going on with students. They need to step up to the plate, not just school’s over and everybody goes home. We need to involve the parents as well. Kids are not going to tell their parents some things.
No matter what our role in life, parent or health care provider, we need to be aware so that we can help a child or an adolescent. We have to ask the questions to be able to help.
Source: http://centerfortotalhealth.org/2012/bullying-a-physicians-perspective/
American Diabetes Month® | The Importance of Comprehensive Eye Exams
“The American Optometric Association (AOA) is reminding Americans with diabetes about the importance of scheduling annual, dilated comprehensive eye exams to help detect and even prevent eye and vision disorders that could lead to blindness,” explains ExamHealth. “Each year, 12,000 to 24,000 individuals lose their sight because of diabetes.” An all-too-common condition in the US, the American Diabetes Foundation reports that nearly 26 million Americans are living with the condition.
What’s more, “The AOA notes that the results from its 2012 American Eye-Q® consumer survey revealed that only 44% of Americans are aware that diabetic eye disease often has no visual signs or symptoms,” reports ExamHealth. “Additionally, 43% of Americans are unaware that a person with diabetes should have a comprehensive eye exam once a year.”
Not sure what you should be looking out for? Read on!
Diabetes and Your Eye Health
So, why are comprehensive eye exams so important for those living with diabetes? The answer is simple – those with diabetes are at a significantly higher risk for developing several of today’s most serious eye conditions. Here’s a brief introduction:
- Glaucoma: Glaucoma is an eye disorder characterized by an increased pressure in the eye. A leading cause of blindness in the US, glaucoma is a progressive condition that causes a gradual loss of vision. And, while there is no cure, glaucoma can often be treated with eye drops and certain other medications. In some cases, we treat the condition with lasers or surgery. A condition where early detection is everything, diabetes sufferers need to be even more vigilant when it comes to regular glaucoma screenings.
- Cataracts: You can think of a cataract as a clouding of the eye’s lens. A progressive condition, cataracts can ultimately affect one’s ability to see clearly. Most common among older patients, those with diabetes are also at an elevated risk for developing the condition. When it comes to treatment, patients will often benefit from Cataract Surgery. During the procedure, the eye’s natural lens is removed and replaced with an artificial lens also known as an Intraocular Lens (IOL).
- Diabetic Retinopathy: Diabetic retinopathy is a condition that weakens the blood vessels that supply nourishment to the retina. This is the light-sensitive lining in the back of the eye where vision is focused. As these vessels leak, swell or develop thin branches, vision loss can ultimately occur. Our practice offers comprehensive Diabetic Eye Care including routine eye exams.
Schedule Your Eye Exam Today
Make sure you schedule your comprehensive eye exam this November! Our offices are located in in Winchester, serving Virginia, West Virginia and Maryland, and you can reach us directly at (540) 722-6200. Contact us today.
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Monday, April 29, 2013
Measles in Pakistan
There has been an upsurge in cases of measles in Pakistan, particularly Karachi and Rawalpindi.
Travellers going to Pakistan should make sure they are immune to measles, either through natural immunity or vaccination.
It is now recommended that two doses of the MMR vaccine are given to ensure a high level of immunity.
Source: ProMed Newsgroup
For advice about dengue fever and other travel related illnesses and travel vaccinations, contact the Globe Travel Health Centre in Norwich on 01603 667323
Treatment for Lumbar Radiculopathy Video
The treatment for lumbar radiculopathy focuses around removing the nerve pressure and building strength in the back muscles so the pain does not recur.
Video presented by Grant Cooper, MD
This video accompanies the article: Lumbar Radiculopathy.
Video Transcript
Treating lumbar radiculopathy begins with a good understanding of what's causing the radiculopathy and the anatomy that is involved. Often one of the first approaches is to address the biomechanics - physical therapy. It's stretching, strengthening, it's trying to get all the muscles right to help take the pressure off of the spine, off of the hole where the nerve comes out so that the nerves have a chance to heal. When someone's going to physical therapy there will often be more passive modalities like ultrasound, like electrostimulation, manual manipulation, some traction - all of these different passive modalities, along with others, designed to help also reduce the inflammation around the nerve root.
If the pain is continuing or if the pain is interfering with a person's ability to do the exercises with physical therapy, then physicians also have different kinds of injections to reduce the inflammation around the nerve root. Essentially what I'm talking about is epidural steroid injections. There are two basic ways of getting medicine into the epidural space for this kind of a problem. One is coming from behind the disc and the nerve root and one is more of a transforaminal approach. Here's a spine and here's where nerves exit the spine on the side. You can either come with a needle and you can put medicine right next to the nerve root as the nerve exits the spine or you can come from behind it in a couple of different ways in order to basically get some steroid around the nerve root.
Now, an epidural steroid injection is not going to change the arthritis that may be leading to radiculopathy. It's not going to change a herniated disc. It's not going to mask anything either. What it's going to do is it's going to reset the inflammatory clock back down to zero or close to zero. What this does is it allows the patient to, ideally, do more with physical therapy to take advantage of a window of opportunity during which they can do more stretching, do more strengthening and this can help tweak the biomechanics so we're not sitting back there in 3 months/6 months/1 year having to repeat those kinds of injections.
Oral medications can also be helpful to control the symptoms while a patient is going through physical therapy, stretching, strengthening, giving it some time in order to allow the nerve to heal. When more conservative measures aren't effective - in those relatively rare instances - there are surgical alternatives, depending on the underlying anatomy. Sometimes a surgery can be as simple as a discectomy to take out a piece of the disc and sometimes, depending on the pathophysiologic processes going on in the spine, the surgery may have to be more involved.
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Source: http://www.spine-health.com/video/treatment-lumbar-radiculopathy-video
The incidence of MCI differs by subtype and is higher in men: The Mayo Clinic Study of Aging
Rosebud O. Roberts, M.B.Ch.B. with the Division of Epidemiology, discusses a study that measured the incidence of MCI and its subtypes using published criteria. Results showed a statistically significant difference between incidence rates among men and women. The study also found that individuals with only a high school education developed either aMCI or naMCI at a higher rate than those with some higher education.
The study was published in the Jan. 25, 2012, issue of Neurology.
ABSTRACT
Objective
Although incidence rates for mild cognitive impairment (MCI) have been reported, few studies were specifically designed to measure the incidence of MCI and its subtypes using published criteria. This study estimates the incidence of amnestic MCI (aMCI) and nonamnestic MCI (naMCI) in men and women separately.
Methods
A population-based prospective cohort of Olmsted County, Minn., residents age 70 to 89 on Oct. 1, 2004, underwent baseline and 15-month interval evaluations that included:
- The Clinical Dementia Rating scale
- A neurologic evaluation
- Neuropsychological testing
A panel of examiners blinded to previous diagnoses reviewed data at each serial evaluation to assess cognitive status according to published criteria.
Results
Among 1,450 subjects who were cognitively normal at baseline, 296 developed MCI.
The age- and sex-standardized incidence rate of MCI was 63.6 (per 1,000 person-years) overall, and was higher in men (72.4) than women (57.3) and for aMCI (37.7) than naMCI (14.7).
The incidence rate of aMCI was higher for men (43.9) than women (33.3), and for subjects with ≤12 years of education (42.6) than higher education (32.5).
The risk of naMCI was also higher for men (20.0) than women (10.9) and for subjects with ≤12 years of education (20.3) than higher education (10.2).
Conclusions
The incidence rates for MCI are substantial. Differences in incidence rates by clinical subtype and by sex suggest that risk factors for MCI should be investigated separately for aMCI and naMCI, and in men and women.
Authors
Rosebud.O. Roberts, M.B.Ch.B., Yonas E. Geda, M.D., David S. Knopman, M.D., Ruth H. Cha, Vernon (Shane).S. Pankratz, Ph.D., Bradley F. Boeve, M.D., Eric G. Tangalos, M.D., Robert J. Ivnik, Ph.D., L.P., Walter A. Rocca, M.D., Ronald C. Petersen, M.D., Ph.D.
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Cholera outbreak in Malaysian Borneo
New cases of cholera continue to reported in the Bintulu district of Borneo. Travellers should avoid buying drinks with ice, uncooked salad dishes and ice-cream, as the water used may not have been boiled to decontaminate it. They should also avoid premises that are not spotlessly clean.
Source: ProMed Newsgroup
For further advice, contact the Globe Travel Health Centre on 01603 667323
Reducing our Environmental Impact to Create Healthy Communities
Note: Today we have a guest blog post from Bernard Tyson, president and chief operating officer of Kaiser Foundation Hospitals, Inc., and Kaiser Foundation Health Plan. He recently wrote about Kaiser Permanente’s work to reduce its environmental footprint – not just as an business imperative, but as a core strategy for improving the health of its members and the communities it serves. Read more about Bernard Tyson through his bio in the Kaiser Permanente News Center.
There is little disagreement that greenhouse gas emissions, which are known contributors to climate change, have led to a rise in pollution and adverse health impacts. In fact, the World Health Organization estimates that urban air pollution causes about 1.2 million deaths per year and exacerbates cardiovascular and respiratory illnesses, particularly in sensitive populations like the elderly and young and in minority communities that are disproportionately impacted by urban and industrial activities.
Ironically, the health care industry – responsible for preventing and treating these types of illnesses – also contributes to the problem. According to a study by the University of Chicago, 8 percent of the total carbon emissions in the United States are attributable to health care activities. Not surprisingly, hospitals are by far the largest carbon emitters due in large part to strict requirements for temperature control, ventilation and lighting, and, of course, 24/7 operations.
Compounding the problem is the fact that many hospitals and health care facilities were built decades ago and have not been remodeled to use energy more efficiently. This is a similar situation to many government-owned buildings across the country. Late last year President Obama announced a multi-billion dollar government and private sector commitment to finance building renovations to make government-owned properties more energy efficient, and to create jobs in the process. The energy performance contracts proposed by the federal government, with improvements paid for by energy savings, are similar to those being used by schools, colleges and municipalities.
Given that the health care industry in America has nearly 600,000 facilities – and many of their workforces are equal in size to large government agencies (Kaiser Permanente’s workforce, for example, is of similar size as the U.S. Department of Homeland Security), health care organizations have a real opportunity to adopt sustainable business practices that reduce emissions, increase energy efficiency and the use of clean energy. This in turn will better protect public health and create jobs, achieving results that are in line with our focus on wellness and prevention, and helping grow the economy.
In January, Kaiser Permanente set an aggressive business strategy of reducing our greenhouse gas emissions by 30 percent by 2020, as compared to 2008 levels. To achieve this goal, we are adopting sustainable energy measures, both related to the construction of new facilities and the upgrading of existing facilities, such as installing new lights and window-film installations. These measures will not only reduce the impact of our operations on the environment, but are expected to save roughly $1 million per year in energy costs as well, which is good news for our members.
We are also investing in clean energy sources, such as deploying solar energy and fuel cell generation capacity at facilities throughout California. In Maryland and the District of Columbia, we are purchasing renewable energy credits to offset 100 percent of our carbon intensive activities in those markets.
And Kaiser Permanente is not alone. Last year for Earth Day, Digital Health committed to reducing greenhouse gas emissions and energy use, and increasing sourcing of power to green energy. The University of California at San Francisco has also established a robust sustainability strategy to reduce carbon emissions with an ultimate goal of becoming climate neutral.
I hope these climate change commitments are just the beginning for our industry. Together, we have an opportunity – and a responsibility – to help prevent climate related illnesses and improve the health of our communities.
Source: http://centerfortotalhealth.org/2012/tyson-healthy-communities/
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MHC to hold World AIDS Day Event
World AIDS Day is held each December 1st as an opportunity for people to unite in the fight against HIV/AIDS by increasing awareness, fighting prejudice and improving education. It is also an opportunity to show support for people living with HIV and to commemorate people who have died.
Memphis Health Center, Inc. will observe Word AIDS Day on Friday, November 30, 2012 with a Candle Light Memorial in our main conference room located at 360 E. H. Crump Blvd 10:45 am – 12:00 pm. This event will highlight HIV awareness, and the importance of testing. We will also feature a video & testimonials of individuals that have been impacted by this disease.
For more information, please contact Latonya Foster, Health Educator, at (901) 261-2007 or by email at lfoster@mphshc.org.
Sunday, April 28, 2013
Implantable Contact Lenses Certification
Dr. Grochmal recently attended a conference to expand his services to increase his refractive surgery options for his patients in Baltimore. Implantable contact lenses (ICL’s) are a great alternative for patients who are not qualified for LASIK or are borderline. Often times, the glasses’ prescription is outside the range for safe and effective LASIK; or the cornea is too thin for LASIK. ICL’s will correct for high hyperopia as well as high myopia without altering the cornea’s natural refractive powers. Please contact Grochmal Eye Center to learn more.
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Careers As Advanced Health Care Practitioner In Demand
According to data collected by the American Medical Group Association’s and Cejka Search 2011 Physician Retention Survey, careers in the advanced health care field are growing rapidly. As such, employment in medical groups for nurse practitioners (“NPs”) and physician assistants (“PAs”) has increased significantly in the past five years. According to the data, 75% of the responses to the survey indicated more NPs and PAs will be hired in the next five years.
Growth in these advanced health care professions is due largely to economics, according to an article in U.S. News and World Report. NPs, for example, can provide patients with many primary health care services at a fraction of the cost of an internist. In addition, FiercePracticeManagement reports that due to physician shortages and the demand to create a medical “team” to care for patients (accountable care organizations, “ACO”), medical groups are employing the NP and PA at increasingly high rates. This gives NPs and PAs the advantage of choosing where to work, thus creating a high turnover rate for these positions. In addition, recruiting and retaining these professionals are challenges to medical groups.
Meiselman, Denlea, Packman, Carton & Eberz P.C. offers legal advice to physicians on medical issues. If you need legal assistance or guidance on a matter regarding your practice, please call our office.
Source: http://www.pagingdrblog.com/2012/04/17/careers-as-advanced-health-care-practitioner-in-demand/
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Baltimore Laser Eye Surgeon Discusses the Future of Advanced Cataract Surgery
Cataract Surgeon in Baltimore Discusses the Future of Advanced Procedures
Baltimore, MD — According to the latest statistics from the American Academy of Ophthalmology (AAO), cataracts affect nearly 22 million Americans age 40 and older. However, Dr. Jay C. Grochmal, a LASIK and cataract surgeon in Baltimore, says with the recent advancements in cataract surgery, patients do not have to let blurring vision hinder their daily life. Dr. Grochmal discusses the latest innovations in refractive-cataract surgery and how they can benefit patients looking to improve their vision.
At his Baltimore cataract surgery practice, Dr. Grochmal says the aging baby boomer population has brought an influx of patients needing vision correction for cataracts and other age-related conditions. Cataracts develop as people get older and are exhibited in a clouding and opaqueness of the natural lens inside one’s eye, causing vision to blur. The AAO report also shows that by age 80, more than half of all Americans will have visually significant cataracts. Dr. Grochmal says while cataracts can be a bothersome medical issue, the good news is that advancements in ophthalmology and surgical techniques have made clear vision an affordable and effective option through cataract surgery.
With procedures such as laser refractive cataract surgery on the horizon, Dr. Grochmal says treatment is now ultimately safer than ever before and more successful in helping patients achieve improved vision with less dependence on glasses. He says other innovations have helped create smaller incisions for lens extraction and replacement during cataract surgery, and through technology such as the Zeiss IOL Master, doctors can better measure the power of the intraocular lenses and offer more accurate visual results. “With the safety of cataract surgery improving, patients no longer have to wait for their vision to drastically deteriorate before undergoing cataract surgery. Also, the quality of newer IOL’s are allowing excellent vision after surgery,” says Dr. Grochmal.
Thanks to a diverse arsenal of lenses such as toric and multifocal IOL’s, Dr. Grochmal says patients can now enjoy the benefits of custom treatment for their individual eye condition and lifestyle needs. Whether patients wish to enhance their vision up close or far away or find a balance of clarity in both distance and near vision, he says there is a solution for every patient’s desires. Dr. Grochmal says cataract surgery recovery is now also much quicker and requires less trauma to the function of one’s eye. “With such small incisions now possible and the availability of toric IOL’s, post operative astigmatism can be minimized if not completely corrected,” he says.
Regardless of whether patients are looking for cataract surgery or another vision correction procedure such as LASIK in Baltimore, Dr. Grochmal says the advancements in ophthalmology are making significant strides towards helping people attain perfect, lasting eyesight. He adds that he is excited to see the further development of patient comfort and care and hopes patients continue to take advantage of the benefits that procedures like cataract surgery can offer.
About Jay C. Grochmal, MD
Dr. Jay C. Grochmal received his medical degree from the University of Maryland, after which he completed a rotating internship at the U.S. Public Health Hospital in Baltimore. He also completed a residency in the Department of Ophthalmology at the Greater Baltimore Medical Center, where he was Chief Resident. A member of the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery, Dr. Grochmal has participated in several medical mission trips to offer his experience and skills in vision correction to patients in Pakistan, Jamaica, and the Bahamas. He is currently on staff with the Greater Baltimore Medical Center and St. Agnes Hospital. He is the medical director at the Snowden River Surgery Center.
Located at 405 Frederick Rd, Suite 102 in Baltimore, MD, Dr. Grochmal’s practice can be reached at (410) 697-4090. He can also be contacted online via the website grochmaleye.com or facebook.com/grochmaleye.
Contact:
Rosemont Media
Aaron Hurst
aaron@rosemontmedia.com
(858) 200-0044
www.rosemontmedia.com
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MHC Partners with the South Memphis Alliance to provide free HIV & Syphilis Screening!
will provide free HIV & SYPHILIS TESTING
WEDNESDAY, JUNE 27, 2012
10:00 AM – 2:00 PM
360 E. H. Crump Blvd.
FREE REFRESHMENTS, & GIVE A-WAYS WHILE SUPPLIES LAST
Source: http://www.memphishealthcenter.org/blog/?p=193
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Federal Government Questions Legality Of Certain ASC-Service Provider Arrangements
Recently, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services issued an advisory opinion regarding two types of Proposed Arrangements between an anesthesia provider (AP) and physician-owned ambulatory surgery centers (ASCs). This came as a result of a request for an opinion from an AP who, because of competitive market pressures, was considering one of two new business relationship models. Under the AP’s current professional arrangement, the ap offers exclusive anesthesia services to ASCs, employs personnel to meet the anesthesia needs of the ASCs, and independently bills patients and third party payors, including Medicare, for professional fees. The ASCs bill the same parties for professional services plus a facility fee for materials and ancillary staff.
- Under Proposed Arrangement A, the AP would continue to provide exclusive anesthesia services to the ASC and to bill independently. Additionally, the AP would pay a market value “management services” fee to the ASC for each non-Federally funded patient. The ASC would both collect this fee and continue to charge a facility fee to Federal and third party payors.
- Under Proposed Arrangement B, the ASC physician-owners would set up a separate subsidiary to exclusively provide anesthesia services to their patients. The subsidiary then would hire the AP as the exclusive independent anesthesia services contractor, handle all billing with the assistance of the AP and its staff, pay the AP out of fees collected, and retain any profits.
In analyzing the legality of the two arrangements, the OIG considered two questions: 1. Does either arrangement violate the Federal anti-kickback statute, and, 2. Would any safe harbor protection apply?
Under the anti-kickback statute, it is a criminal offense to offer, pay, solicit, or receive any remuneration for referrals reimbursable by a Federal health care program. This statute seeks to ensure that referrals are based on sound medical judgment and not financial or other incentives. Regarding Proposed Arrangement A, although the AP would pay a management services fee only for non-Federal health care program patients, this does not reduce the risk that the fee might be paid by the AP to induce referrals from the ASC of all types of patients. Additionally, the arrangement allows the ASC to be paid twice for the same services, and this could unduly influence the ASC to select the AP as the exclusive provider. The OIG concluded that Proposed Arrangement A could violate the anti-kickback statute. No safe harbor protections apply.
Safe harbor protections for ASCs, employment, and personal services and management contracts were determined to not apply to Proposed Arrangement B. The Subsidiary does not qualify as a Medicare-certified ASC because it would not provide surgical services, only anesthesia services. As such, its income and the profits distributed to the ASC physician-owners would not be protected by any safe harbor provisions. Additionally, the OIG is concerned about exclusive arrangements between those who refer business (the ASC physician-owners), and those who furnish goods or services reimbursed by a Federal health care program (the AP). The AP and the ASC physician-owners both would benefit financially in Proposed Arrangement B, with the AP receiving its negotiated rate and the physician-owners receiving residual profits from the subsidiary after expenses and payment to the AP. The OIG concluded that Proposed Arrangement B would permit the physician-owners to receive compensation in the form of profits from the subsidiary from referring patients to the AP; this payment would be for services that they themselves could not provide. The more than minimal risk of fraud and abuse and the prohibited remuneration both would be in violation of the Federal anti-kickback statute.
Physicians should be aware of this development, as it may affect current and future professional relationships. A health care attorney can offer assistance in interpreting the potential impact of the OIG decision and evaluating the need to restructure business arrangements.
Measles in Pakistan
There has been an upsurge in cases of measles in Pakistan, particularly Karachi and Rawalpindi.
Travellers going to Pakistan should make sure they are immune to measles, either through natural immunity or vaccination.
It is now recommended that two doses of the MMR vaccine are given to ensure a high level of immunity.
Source: ProMed Newsgroup
For advice about dengue fever and other travel related illnesses and travel vaccinations, contact the Globe Travel Health Centre in Norwich on 01603 667323
Saturday, April 27, 2013
Increase in mosquitos carrying dengue fever in Cuba
There has been an increase in the numbers of Aedes aegypti mosquitos in urban areas of Cuba, including Havana.
These insects can carry dengue fever, an unpleasant viral disease, (commonly named breakbone fever due to the severe joint and muscle pain involved). The authorities have established a surveillance system to monitor the situation, but travellers should nevertheless take steps to avoid being bitten by these mosquitos, which are active and biting during daylight hours.
Source: Agence France-Presse
For further advice, contact the Globe Travel Health Centre on 01603 667323
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3 Eye Conditions You Need to Be Thinking About
Did you know that eye disorders are much more common among those of a certain age? We’re not just talking about needing a stronger eyeglass prescription, but rather diseases that can completely reduce your ability to see if left untreated. Want to know what to watch out for?
Here is our list of the Top 3 Age-Related Eye Conditions You Need to Be Thinking About:
- Macular Degeneration: Age-related macular degeneration (AMD) can present itself in different ways – from a blurry area of vision to a dark blind spot. The condition occurs when arteries that nourish the retina harden. Now deprived of vital nutrients, these retinal tissues begin to weaken, which ultimately causes vision loss. As the number-one cause of vision loss in the US, any AMD symptoms need to be addressed as soon as possible. The best way is to schedule a Macular Degeneration Evaluation.
- Cataracts: Cataracts are one of the most common eye concerns for those over the age of 65. The condition, which affects millions of people each year, causes a clouding of the eye’s natural lens. Often, the only good cataract treatment is surgery. During a typical Cataract Surgery, the eye is numbed and a small ultrasonic probe is inserted. This probe breaks up and removes the affected cloudy lens. A clear new artificial lens called an IOL is then implanted into the eye.
- Glaucoma: Glaucoma is a common eye condition, commonly associated with an increased pressure in the eye. This increased pressure can damage the optic nerve and ultimately cause a gradual but serious loss of vision. Untreated, the disease often results in complete blindness. While not curable, modern medicine offers several advanced Glaucoma Treatments. These include medications, eye drops and sometimes, surgery.
Get Checked! Schedule an Appointment Today
To learn more about these or any of the age-related conditions you should be watching out for, contact us today and schedule an appointment. Our offices are located in Winchester, serving Virginia, West Virginia and Maryland. Call us directly at (540) 722-6200. We look forward to meeting you.
Source: http://www.seeclear.com/blog/eye-heath/3-eye-conditions-you-need-to-be-thinking-about
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Food Banks Look to Offer More Nutritious Food
With the holiday season upon us, many turn their thoughts to the importance of food banks to provide healthy meals for those in need. In fact, nearly 6.1 million U.S. households rely annually on food banks and pantries for their meals, and not just at Thanksgiving. To make sure that food banks provide nutrition as well as sustenance, several food banks are redefining their standard food offerings and working to make nutritious, healthy foods more available. The 12 participating food banks are part of the Healthy Options, Healthy Meals™ initiative, a partnership between MAZON: A Jewish Response to Hunger, and Kaiser Permanente. The Center for Total Health blog recently spoke with Marla Feldman, director for the Healthy Options, Healthy Meals™ initiative to learn more about this important work.
CTH blog:
Tell us about your organization and your approach to preventing hunger in our society.
Marla Feldman:
A Jewish Response to Hunger is a national nonprofit organization working to end hunger among people of all faiths and backgrounds in the United States and Israel. Since our founding in 1985, MAZON has practiced and promoted a holistic approach to preventing hunger, advocating to ensure that hungry people have access to the nutritious food they need today and working to develop and advance long-term solutions so that no one goes hungry tomorrow.
CTH blog:
What are you seeing right now in terms of demand for emergency food assistance and how food banks are meeting this demand?
Marla Feldman:
The downturn in the economy has caused tremendous growth in demand at food banks and food pantries—between 30-70 percent year-over-year since 2009—coupled with an appreciable decrease in donations to their organizations. Needless to say, these challenges put a significant strain on emergency food providers’ ability to meet the needs of hungry people in their communities, and many are struggling to keep up.
CTH blog:
You recently partnered with Kaiser Permanente on the Healthy Options, Healthy Meals™ initiative. What is the primary goal of the initiative and how did it originate?
Marla Feldman:
The goal of Healthy Options, Healthy Meals™ is simple: to get healthier food to the people who need it—specifically, those who must rely on food banks to feed their families.
MAZON has been helping to increase capacity within the anti-hunger community for 15 years. From 1998 to 2010, MAZON hosted annual conferences bringing California’s anti-hunger community together to discuss current budget and policy priorities and help direct their advocacy efforts. By 2003, our conference presented workshops that explored ways the anti-hunger community could play a lead role in preventing obesity and diet-related illnesses. Those initial discussions led to the 2007 launch of a three-year California initiative to promote healthier eating in low-income communities. This program attracted the interest of Kaiser Permanente, and Healthy Options, Healthy Meals™ was born.
It is important to note that food banks began in the 1970s with the intention of gathering surplus food to distribute as a stopgap measure to help people get through emergency situations. Whether or not the food that was provided was nutritious wasn’t really a primary issue, because it was providing for a need that was temporary. But as the role of food banks has evolved over time, food banks have had to adapt and grow. Now, with the rise in obesity and its relationship to food insecurity, food banks have come to embrace the role they play not only in alleviating hunger, but also in building healthier communities.
CTH blog:
Why is it so important to establish formal nutrition policies at food banks? Tell us more about the collaborative process you are engaging in to create these policies and the successes you’re seeing.
Marla Feldman:
In a nutshell, formal, written nutrition policies provide a concrete blueprint for how emergency food providers can increase the nutritional quality of the foods and beverages they distribute. Having policies is important for a number of reasons: they provide guidance in ambiguous situations, where “common sense” and good intentions may not be enough; they ensure continuity and consistency through staff changes; they support educating donors about the types of donations they prefer to receive; they help steer outreach and nutrition education efforts; and they change the way food banks are talking about their work. This process is about building organizational culture and making organizational changes that are helping food banks become nutrition banks.
Creating a nutrition policy is a more complex task than you might think, because the most effective ones are created through a deliberate process of cooperation and collaboration of all organizational stakeholders—from the Board of Directors and Executive Director to those who work in the warehouse; from procurement staff to marketing to operations; and from donors to agencies to clients. Engaging so many key stakeholders in the policy development process is not the cultural norm for food banks. That’s why our Healthy Options, Healthy Meals™ initiative is so revolutionary and important.
CTH blog:
What’s the best thing one person can do right now to help those in need get access to nutritious food?
Marla Feldman:
As a long-time employee of an anti-hunger advocacy organization, I’d have to say that it’s paramount that we create the political will to end hunger and malnutrition in America. I’d encourage people to get out and advocate on behalf of those who are vulnerable. Impress upon your federal and state policymakers that we will no longer accept that 50 million people, in the wealthiest country in the world, struggle to put nutritious food on the table. It’s much easier than you think to call your Senator and Congressperson or to make an appointment to speak with someone in their office. And, rest assured, they do want to hear from you, and it does make a difference!
Source: http://centerfortotalhealth.org/2012/food-banks-look-to-offer-more-nutritious-food/
What is Natural Cycle IVF?
Conventional IVF Today’s conventional IVF is ‘stimulated’ – drugs are used to prompt the woman’s ovaries to produce several eggs, rather than just one. The eggs are mixed with her partner’s or a donor’s sperm to become fertilised. Women take a course of ovarian-suppression hormones to shut down their menstrual cycle to control ovulation. Then [...]
Source: http://www.createhealthclinics.org/blog/natural-cycle-ivf/what-is-natural-cycle-ivf/
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What is Natural Cycle IVF?
Conventional IVF Today’s conventional IVF is ‘stimulated’ – drugs are used to prompt the woman’s ovaries to produce several eggs, rather than just one. The eggs are mixed with her partner’s or a donor’s sperm to become fertilised. Women take a course of ovarian-suppression hormones to shut down their menstrual cycle to control ovulation. Then [...]
Source: http://www.createhealthclinics.org/blog/natural-cycle-ivf/what-is-natural-cycle-ivf/
Friday, April 26, 2013
MHC to hold World AIDS Day Event
World AIDS Day is held each December 1st as an opportunity for people to unite in the fight against HIV/AIDS by increasing awareness, fighting prejudice and improving education. It is also an opportunity to show support for people living with HIV and to commemorate people who have died.
Memphis Health Center, Inc. will observe Word AIDS Day on Friday, November 30, 2012 with a Candle Light Memorial in our main conference room located at 360 E. H. Crump Blvd 10:45 am – 12:00 pm. This event will highlight HIV awareness, and the importance of testing. We will also feature a video & testimonials of individuals that have been impacted by this disease.
For more information, please contact Latonya Foster, Health Educator, at (901) 261-2007 or by email at lfoster@mphshc.org.
Bullying: A Physician’s Perspective
CTH Blog:
Bullying has been getting a lot more attention in the media, and it appears to be taken a lot more seriously now than in the past. As the chief of adolescent medicine for Kaiser Permanente in San Francisco, have you seen any increase in your practice in the number of adolescents coming in with concerns related to bullying?
Charles Wibbelsman:
In my own practice, I’ve seen an increase in bullying, anecdotally speaking, and that increase is reflected nationally as well. I was reading in The Journal of the American Medical Association, that 20 to 30 percent of students are involved in bullying – either as perpetrators or as victims.
We’ve had a teen clinic since 1955. When Solomon Cohen set up this clinic for adolescents ages 11 to 19, we were the only teen clinic in 1955, and we were one of the first teen clinics in the United States.
Bullying has changed over the last 20 years. It used to be that bullying would occur in the schools—students making fun of or physically assaulting other students, guys beating each other up, but now you have cyber bulling – social media, texting, Twitter, Facebook, and on-line videos. And, with cyber bullying, it’s mostly girls. Cyber bullying is twice as common among girls than boys.
CTH Blog:
Do you think bullying is becoming more common, or are people less tolerant of it now?
CW:
Bullying is more common because the factors involved in bullying are not just physical or verbal in a school setting. Again, now we have the bullying online as well. People are talking about it now. We’re seeing it in every type of media. People are more aware of it. It used to happen in the schools, and often teachers and parents weren’t aware of it. Now, people don’t look the other way. They are taking some responsibility.
CTH Blog:
The ramifications of bullying are serious. In addition to physical harm (from others or self), what are some of the health risks associated with bullying—the psychological and emotional health concerns that people may experience in response to bullying, such as anxiety, depression, headaches, or nausea?
CW:
There are serious health risks. Low self-esteem, depression, substance abuse, and suicide attempts. There are more than 250,000 attempted suicides, and 5,000 completed suicides among teens each year. The case of Rutgers University student Tyler Clementi, whose roommate filmed him being intimate with another man in a dorm room and uploaded the video, is an example of what can happen with bullying. Tyler committed suicide by jumping off the George Washington Bridge.
CTH Blog:
When you hear of tragedies such as what took place with Tyler Clementi, what is your reaction? There have been a growing number of adolescent and teen suicides that have been linked to bullying.
CW:
One of the saddest parts of my work was two years ago. A 14-year-old boy hung himself. He was one of my patients. His girlfriend broke up with him. He was popular, had lots of friends, good grades, played sports… It was horrible. It shows you how sensitive, vulnerable one is at that age. You don’t have the life experiences to deal with it.
I did a panel in San Francisco at the American Academy of Pediatrics, and there were LGBT youth talking about their own experiences being the victims of bullying. They were in their late teens, and all of them said that their worst experiences with bullying were in middle school. They all said, ‘I survived middle school.’ That’s the time when your body is changing, not everybody looks the same, there are school pressures – it’s prime time for bullying. There is decreased self-esteem. Bullying is at its height. Many young adults and adolescents don’t have the defense mechanisms to handle a lot of this.
CTH Blog:
Many kids who experience bullying suffer in silence, fearing retribution if they speak up. What are some of the warning signs adults should look for in kids?
CW:
Sometimes it’s unprotected sexual activity. I see isolation. I see cutting. When I see kids as patients, I ask, is this kid at risk for hurting himself? When I talk to adolescents about sexual orientation, maybe they’re gay or lesbian and haven’t come out yet. They’re very isolated. These are prime victims for bullying.
When we look at an adolescent, or when I’m examining a patient, I’m looking at self-esteem. How do they feel about themselves – their body? How do they relate to their body? If they have low self-esteem, it could be about low socio-economics, body weight, or sexual orientation. So, again, they may be at risk for depression, substance abuse, or suicide attempts.
We really need to talk with young adolescents in middle school, in junior high. Kaiser Permanente’s Educational Theatre Program is designed to do just that. They put on a theater performance called Nightmare on Puberty Street that addresses, in an entertaining way, the issues and difficult topics middle school students face. It looks at things like peer pressure, self-esteem, and bullying. I’m really proud of this program.
CTH Blog:
As a physician, you may be one of the few people an adolescent can talk to. You may be in a position to establish trust and an open line of communication in ways that others may not. What is the role of the health professional when it comes to bullying? Is the topic of bullying a regular part of the doctor-patient dialogue or should it be?
CW:
As a pediatrician, my responsibility as a doctor is to ask during routine checkups, how are you doing in school? I need to find out if he or she doesn’t have any friends, or if their grades are failing. Or, if one of my patients says, for example, ‘I want to change schools,’ that is a big red flag. As a physician, I often have access to information that adolescents don’t tell other people – things about substance abuse, depression, for example. I also partner with other physicians in mental health. At Kaiser Permanente it’s seamless. We’re all under one roof.
The bible of adolescent care is H-E-A-D-S – Home, Education, Activity, Drugs, and Sex. When I see a patient, at some point, I ask the parents to step out. We discuss a whole host of concerns. Home: I ask who do you live with? Do you live with both parents? I also ask about guns. Is there a gun in their life? Because maybe grandpa has a gun in the house, and a teen may have access to a gun. Activity: Are you involved in sports? What do you do in your free time? How much TV do you watch? I ask do you smoke? Sex: I ask them about what’s going on in their life. Are you having sex? Do you want to have sex, or are you being pressured? Because there are all kinds of layers. There could be issues concerning domestic violence. I start with the easier questions first, asking them what they like to do, and so forth. It’s about building trust and rapport.
CTH Blog:
In your practice, you emphasize the importance of communication with parents as well. Do you ask the parents some of these same questions?
CW:
Yes. We have a questionnaire for parents and adolescents. We ask some of the same questions and general questions as well. For example, does your child drink sodas? Is there a gun in the house? Are you concerned about any behaviors in your child? Is your child sad? Do they watch TV? What kind of things does your child like to eat?
CTH Blog:
What can communities and schools do differently to prevent bullying or minimize its effects?
CW:
Schools need to prepare teachers to be educated about bullying and intervene. Schools, principals, and students need to be aware about what’s going on with students. They need to step up to the plate, not just school’s over and everybody goes home. We need to involve the parents as well. Kids are not going to tell their parents some things.
No matter what our role in life, parent or health care provider, we need to be aware so that we can help a child or an adolescent. We have to ask the questions to be able to help.
Source: http://centerfortotalhealth.org/2012/bullying-a-physicians-perspective/
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Changes are Coming to Your Health Savings Accounts
If you have questions about the coming changes, or if you would like to set up a consultation for LASIK or other laser vision correction procedures, please contact Grochmal Eye Center at (410) 697-4090.
Source: http://www.grochmaleye.com/blog/hsa-flex-spending-account/
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Influenza in the United States
There has been a severe start to the flu season in North America, with many more people than usual falling ill.
Travellers visiting America should be vaccinated against influenza.
Influenza may also be caught anywhere where there are crowds of people in close proximity, such as shops, airports, cinemas, etc.
For advice about influenza and other travel related illnesses and vaccinations, contact the Globe Travel Health Centre in Norwich on 01603 667323 – we have influenza vaccine in stock and can vaccinate anybody over the age of one year against flu
Interview With Wendy Schauer – Author of The 7 Steps To Amazing Health!
Here is a link to an interview that “foodie”, health advocate, and grass fed beef rancher Lisa Wilcox recently did with author Wendy Schauer.
Yours In Health!
G.E. Moon II
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